Airway Microbiome and Development of Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review

Pammi, Mohan; Lal, Charitharth Vivek; Wagner, Brandie D.; Mourani, Peter M.; Lohmann, Pablo; Luna, Ruth Ann; Sisson, Amy; Shivanna, Binoy; Hollister, Emily B.; Abman, Steven H.; Versalovic, James; Connett, Gary; Bhandari, Vineet; Ambalavanan, Namasivayam

doi:10.1016/j.jpeds.2018.08.042

Cited by 95 publications

(95 citation statements)

References 24 publications

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“…The healthy microbiome of the URT and LRT plays several important roles in the development and maintenance of homeostasis of the RT and whole organism. The composition of the microbiome at all mucosal sites changes dynamically from the first days of life, shaping the establishment of proper interactions between the microbiota and human body and constituting the critical ''window of opportunity'' for determining future health or disease (Pattaroni et al, 2018;Pammi et al, 2019;Stiemsma and Turvey, 2017). Directly after birth, the skin, gut, nasopharynx, and mouth microbial communities are undifferentiated and colonized by bacterial species reflective of delivery mode (de Steenhuijsen Piters et al, 2015).…”

Section: Asthma Is Not a Single Diseasementioning

confidence: 99%

The Role of Lung and Gut Microbiota in the Pathology of Asthma

et al. 2020

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Section: Asthma Is Not a Single Diseasementioning

confidence: 99%

The Role of Lung and Gut Microbiota in the Pathology of Asthma

et al. 2020

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“…A recent systematic review identified six studies that have evaluated the airway microbiome in preterm infants that developed BPD (31). The majority of included studies used amplification of the variable regions of 16S rRNA for bacterial sequencing (16,19,20,27).…”

Section: Airway Microbial Signatures and Bpd Developmentmentioning

confidence: 99%

Predicting BPD: Lessons Learned From the Airway Microbiome of Preterm Infants

Gentle

Lal

2020

Front. Pediatr.

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Bronchopulmonary dysplasia (BPD) is the chronic lung disease of prematurity with an operational definition, various different clinical phenotypes, and a complex, multifactorial etiology. Newer unbiased systems biology approaches have identified various "omic" factors associated with the pathogenesis and prediction of BPD. Recent microbi "omic" studies have discovered that airways of newborns harbor a low biomass but distinct microbiome signature as early as at the time of birth. This early airway microbiome may serve to prime the host immune system and may play a role in modulating the infant's future susceptibility to severe BPD development. Temporal changes are observed in airway microbiome of preterm infants from birth to the diagnosis of BPD, with an overall decrease in bacterial diversity, and development of a relative dysbiosis marked by increased Gammaproteobacteria and decreased Lactobacilli abundance. This review will summarize previous investigations of the airway microbiome in preterm infants, appraise the utility of using the airway microbiome to predict BPD development, discuss possible molecular mechanisms involved, and speculate on future microbiome-mediated therapeutics for BPD.

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“…Some reports described changes in airway microbiome and increased bacterial load early in life of preterm infants and linking these changes to later pulmonary complications such as bronchopulmonary dysplasia. 14 Given our findings at our institution, we adopted specific guidelines for diagnosis and treatment of PNA that include sampling of those patients who meet criteria for clinical PNA (this may include an electronic reminder of the guidelines) and include providers' education regarding the nature of infant airway colonization.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Tracheal Fluid Culture Sampling Method and Culture Results on Antibiotic Use in Neonates

Attar

Iannetta

Mitri

et al. 2020

J Pediatr Infect Dis

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Objective As part of quality improvement effort to decrease antibiotic use for presumed pneumonia (PNA) in our neonatal intensive care unit, we introduced minibronchoalveolar lavage (mBAL) to obtain culture specimens. We evaluated the effect of tracheal sampling method and culture results on antibiotic use. Methods We performed a retrospective review of culture results of samples obtained by tracheal aspirates (TAs) and mBAL between January 2017 and April 2018. Noting the time cultures were obtained, we reviewed the records to determine if the patients met the Center for Disease Control and Prevention (CDC) criteria for PNA and evaluated culture results and antibiotic treatment practice. Fisher's exact and Mann–Whitney's tests when appropriate were used for the analysis. Results Thirty-five (35) mBAL (on 21 patients) and 42 TAs (on 39 patients) were done prior to antibiotic therapy. The tests were done at similar median day of life in both groups (mBAL 55 days and TA 62 days). The frequencies of positive culture were similar in both groups (mBAL 60% and TA 57%). At the time of obtaining the sample, more mBAL patients met the CDC criteria for PNA (mBAL 54% and TA 26%). Antibiotic days and duration of antibiotic treatment were significantly higher in the mBAL group compared with the TA group. In patient with no clinical PNA, antibiotic days were significantly higher in those with positive cultures (which more likely reflect colonizing microbes) than those with negative cultures and were also higher in the mBAL group than in the TA group. There was a significant increase in the frequency of positive cultures in patients with longer hospital stay. Conclusion Our results show that tracheal cultures on sick neonates with no clinical PNA and with long hospital stay might contribute to unnecessary antibiotic use regardless of the tracheal sampling method.

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Airway Microbiome and Development of Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review

Cited by 95 publications

References 24 publications

The Role of Lung and Gut Microbiota in the Pathology of Asthma

The Role of Lung and Gut Microbiota in the Pathology of Asthma

Predicting BPD: Lessons Learned From the Airway Microbiome of Preterm Infants

The Effect of Tracheal Fluid Culture Sampling Method and Culture Results on Antibiotic Use in Neonates

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